Outcomes 2 years after traumatic spinal cord injury in Botswana: a follow-up study

Löfvenmark, Inka; Wikmar, Lena Nilsson; Hasselberg, Marie; Norrbrink, Cecilia; Hultling, Claes

doi:10.1038/sc.2016.114

Cited by 12 publications

(17 citation statements)

References 13 publications

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“…Only 15% of participants reported muscle spasms as a moderate or chronic problem even though this was the most commonly reported problem on the SCI-SCS. This is a lower rate of complications than reported in comparable studies from LMICs [5,26,27] and even lower than reported from HICs [3,7,[28][29][30]. Similarly, none of the participants in our cohort reported injuries secondary to loss of sensation even though others have found that up to 50% of participants experience this complication [29,30].…”

Section: Discussionsupporting

confidence: 45%

“…All but one participant with a pressure ulcer used a wheelchair for mobility at discharge. These findings probably underestimate the real problems that pressure ulcers pose in LMICs [7,25,26] because those who had already died (n = 81) or were not interviewed for other reasons (n = 4) may have been more likely to have experienced pressure ulcers had they been alive and included [13,14]. Our findings may also not be reflective of the severity of the problem for most people living with SCI in LMICs because the participants in our cohort may have been better able to manage skin problems than most.…”

Section: Discussionmentioning

confidence: 89%

“…Table 1 provides demographic details of the 260 participants: 145 participants used wheelchairs for mobility and 115 were able to walk at discharge. The median (IQR) age at the time of injury was 30 years (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). One hundred and fifty-four (59%) had traumatic paraplegia and 95 (37%) participants had traumatic tetraplegia.…”

Section: Resultsmentioning

confidence: 99%

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Health status, quality of life and socioeconomic situation of people with spinal cord injuries six years after discharge from a hospital in Bangladesh

et al. 2019

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Study design Cross-sectional analysis of a mixed retrospective and prospective inception cohort study. Objectives To determine health status, quality of life and socioeconomic situation of people with spinal cord injuries (SCI) 6 years after discharge from a hospital in Bangladesh. Setting Bangladesh. Methods All patients alive 6 years after discharge from a hospital in Bangladesh were interviewed using the SF12 health survey, the SCI Secondary Conditions Scale, the Centre for Epidemiologic Studies Depression Scale (CESD), and the participation in society items of World Health Organisation Disability Assessment Schedule (WHODAS 2.0). Additional questions determined participants' socioeconomic and employment status. Results The cohort comprised 260 participants: 145 used wheelchairs for mobility and 115 were able to walk at discharge. The median (IQR) Mental and Physical Component scores for the SF12 were 54 (49-57) and 44 (40-51) points, respectively. The median scores for the SCI Secondary Conditions Scale, CESD and WHODAS 2.0 were 8 (4-13), 7 (4-13) and 12 (6-17) points, respectively. Fourteen percent of all participants and 23% of those who used wheelchairs had a pressure ulcer at the time of interview. Forty-four percent of participants were unemployed and 65% were living below the poverty line (median (IQR) income, USD 0 (0-91)) per month. Conclusion Many people with SCI in Bangladesh are unemployed and living in poverty with a reduced quality of life and participation. Pressure ulcers are a common complication.

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Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

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Health status, quality of life and socioeconomic situation of people with spinal cord injuries six years after discharge from a hospital in Bangladesh

et al. 2019

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“…The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. .303 21 24 .591 7 (6-12) 8 (7)(8)(9)(10)(11)(12)(13)(14) .193 33 40 .277…”

Section: Declaration Of Conflicting Interestsmentioning

confidence: 99%

“…Despite improvements in TSI management, resource-constrained settings have not yet benefitted from this progress to the same extent as more developed countries. [6][7][8] Although neurosurgery has been developing in East Africa since the 1940s, it remains tertiary and expensive. 9 Both stabilization techniques and time to surgery for spinal trauma are largely unreported.…”

Section: Introductionmentioning

confidence: 99%

Operative Treatment of Traumatic Spinal Injuries in Tanzania: Surgical Management, Neurologic Outcomes, and Time to Surgery

Magogo

Lazaro

Mango

et al. 2020

Global Spine Journal

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Study Design: Retrospective case series. Objective: Little is known about operative management of traumatic spinal injuries (TSI) in low- and middle-income countries (LMIC). In patients undergoing surgery for TSI in Tanzania, we sought to (1) determine factors involved in the operative decision-making process, specifically implant availability and surgical judgment; (2) report neurologic outcomes; and (3) evaluate time to surgery. Methods: All patients from October 2016 to June 2019 who presented with TSI and underwent surgical stabilization. Fracture type, operation, neurologic status, and time-to-care was collected. Results: Ninety-seven patients underwent operative stabilization, 23 (24%) cervical and 74 (77%) thoracic/lumbar. Cervical operations included 4 (17%) anterior cervical discectomy and fusion with plate, 7 (30%) anterior cervical corpectomy with tricortical iliac crest graft and plate, and 12 (52%) posterior cervical laminectomy and fusion with lateral mass screws. All 74 (100%) of thoracic/lumbar fractures were treated with posterolateral pedicle screws. Short-segment fixation was used in 86%, and constructs often ended at an injured (61%) or junctional (62%) level. Sixteen (17%) patients improved at least 1 ASIA grade. The sole predictor of neurologic improvement was faster time from admission to surgery (odds ratio = 1.04, P = .011, 95%CI = 1.01-1.07). Median (range) time in days included: injury to admission 2 (0-29), admission to operating room 23 (0-81), and operating room to discharge 8 (2-31). Conclusions: In a cohort of LMIC patients with TSI undergoing stabilization, the principle driver of operative decision making was cost of implants. Faster time from admission to surgery was associated with neurologic improvement, yet significant delays to surgery were seen due to patients’ inability to pay for implants. Several themes for improvement emerged: early surgery, implant availability, prehospital transfer, and long-term follow-up.

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Lessons learned from patients with spinal cord injury in managing pressure ulcers: A qualitative study

Gaal

Engelen²,

Adriaansen

et al. 2022

Journal of Tissue Viability

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Outcomes 2 years after traumatic spinal cord injury in Botswana: a follow-up study

Cited by 12 publications

References 13 publications

Health status, quality of life and socioeconomic situation of people with spinal cord injuries six years after discharge from a hospital in Bangladesh

Health status, quality of life and socioeconomic situation of people with spinal cord injuries six years after discharge from a hospital in Bangladesh

Operative Treatment of Traumatic Spinal Injuries in Tanzania: Surgical Management, Neurologic Outcomes, and Time to Surgery

Lessons learned from patients with spinal cord injury in managing pressure ulcers: A qualitative study

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